Endometrial carcinoma (EC) is rare in a young woman with abnormal uterine bleeding. EC is the 3rd most common gynecological cancer and is a disease of postmenopausal women. It is relatively rare in the young reproductive age group (2.1–14.4%). Risk factors are nulliparity, irregular menstruation, diabetes & polycystic ovarian syndrome. A 22-year-old, nulligravid with BMI of 34 kg/m2, consulted due to menorrhagia. Transrectal ultrasound revealed a thickened endometrium (23mm), non-uniform with irregular cystic areas. There was irregular, heterogeneous lesion with largest diameter measuring 3.66cm within the cavity with irregular EMJ with focal disruption at the anterofundal aspect with a colour score of 4 of multifocal origin. A consideration of endometrial pathology was diagnosed with polycystic ovaries. Histopathologic diagnosis revealed endometrial endometrioid adenocarcinoma, FIGO 2. The IETA described endometrioid tumours as having a larger size of tumour, EMJ that is irregular, non-uniform echogenicity and has high colour score with multiple vessels of focal origin. A study of Valentin stated the presence of irregular echogenicity of the endometrium, irregularly branching vessels at power Doppler increases the risk of malignancy. The tumour size appeared to be the single strongest ultrasound predictor of high risk disease. In our case, the sonographic description of the lesion points out to an endometrioid tumour. In a study done by Fischerova, tumours <15mm had regular EMJ (37%) and hyperechoic echogenicity (42%), which are typical features of endometrial hyperplasia. A case of a rare EC in a young: pelvic ultrasound with IETA, has a sensitivity & specificity of 80% & 92% respectively which is significant in detecting endometrial pathologies based on greyscale & colour or power Doppler sonographic findings, hence one should be familiar with its terms and definitions to raise the clinician's awareness toward the appropriate diagnosis and treatment even in young women.